経皮的腎瘻術後の腎動脈瘤の1例

RENAL ANEURYSM AS A COMPLICATION OF PERCUTANEOUS NEPHROSTOMY:A CASE REPORT

　76歳，男性。左腎盂尿管・膀胱腫瘍による左無機能腎・右水腎症に対して右経皮的腎瘻を造設した。間欠的・大量の腎出血が持続したため，右尿管皮膚瘻を造設し腎瘻を抜去したが，出血性ショックおよびタンポナーデを繰り返した。血管造影にて腎動脈瘤を認めたため，選択的動脈塞栓術を行い腎機能を温存し救命しえた。

A 76 year-old male with left renal pelvic and bladder tumor was admitted to our hospital. Nine days after right percutaneous nephrostomy was placed for right hydronephrosis and left nonfunctioning kidney, a massive intermittent renal bleeding occurred. After right cutaneous ureterostomy was made and the nephros-tomy tube was removed, the renal bleeding could not be controlled. Renal angiography revealed an aneurysm of a posterior segmental branch of the right renal artery, and following selective embolization controlled the bleeding was controlled successfully.